| NPI | 1154410785 |
|---|---|
| Former Name | BONNIE ANNE QUAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA31081) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2021-05-04 |