| NPI | 1114117900 |
|---|---|
| Former Name | ERIN ELIZABETH WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.028815) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11192) |
| 225100000X Physical Therapist (Licence: WI 10846-024) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-12-05 |