NPI | 1104224591 |
---|---|
Former Name | JOLIE BREHM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41917) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10914) |
Enumeration Date | 2014-12-17 |
Last Update Date | 2016-11-21 |