| NPI | 1154877512 |
|---|---|
| Former Name | ABIGAIL JANE KETTLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251C2600X (Licence: IN 05010562A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010562A) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2020-02-10 |