NPI | 1083867873 |
---|---|
Former Name | LAURA ENNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501014115) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2008-10-24 |
Last Update Date | 2015-05-29 |