NPI | 1104832245 |
---|---|
Former Name | ANDREA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009003A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 005220) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2016-04-18 |