NPI | 1144251554 |
---|---|
Former Name | COLONY A PACKRONI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018095) |
Additional Taxonomies | 174400000X Specialist (Licence: PA PT018095) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2019-11-08 |