NPI | 1104194729 |
---|---|
Former Name | ASHLEY NICOLE BUIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.018823) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10609) |
Enumeration Date | 2011-12-09 |
Last Update Date | 2017-01-23 |