| NPI | 1104339068 |
|---|---|
| Former Name | NANCY DIANE GUNN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026098) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00738500) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2019-08-23 |