NPI | 1124399548 |
---|---|
Former Name | KATHLEEN DIFFILY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012049) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01431900) |
Enumeration Date | 2012-01-17 |
Last Update Date | 2021-12-17 |