NPI | 1093487696 |
---|---|
Former Name | ERIKA MALTESE GANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63976) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 299821) |
Enumeration Date | 2021-10-01 |
Last Update Date | 2024-08-15 |