| NPI | 1164752564 |
|---|---|
| Former Name | SUSAN VARGHESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36259) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62-027654) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2011-05-19 |