| NPI | 1700287604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MT PTP-PT-LIC-2414) |
| Additional Taxonomies | 225600000X Dance Therapist |
| 225100000X Physical Therapist (Licence: MT 2414) | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2022-01-01 |