NPI | 1124289954 |
---|---|
Former Name | KATHLEEN MERCADO SISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070016179) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 24432) |
Enumeration Date | 2008-06-24 |
Last Update Date | 2015-08-05 |