| NPI | 1053522581 |
|---|---|
| Former Name | LAURA J BONHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2007014584) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MO 2002007670) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-11-05 |