| NPI | 1023279106 |
|---|---|
| Former Name | DESIREE BLAIRE WRIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22569) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2011-01-11 |