NPI | 1093104986 |
---|---|
Former Name | MAURA MANGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 3302) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17071) |
Enumeration Date | 2015-01-14 |
Last Update Date | 2015-09-21 |