| 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 |