NPI | 1083444095 |
---|---|
Former Name | MEGAN BROKUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI CP033154T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 125651) |
Enumeration Date | 2024-08-05 |
Last Update Date | 2025-09-05 |