NPI | 1114481850 |
---|---|
Former Name | MCKENNA SETLIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3910) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014859) |
225100000X Physical Therapist (Licence: OK 5409) | |
Enumeration Date | 2019-01-28 |
Last Update Date | 2021-09-27 |