NPI | 1083132039 |
---|---|
Former Name | KRISTEN PATENAUDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5101) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 5101) |
Enumeration Date | 2017-08-30 |
Last Update Date | 2023-05-30 |