NPI | 1174073357 |
---|---|
Former Name | KRISTINE FRAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT41504) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.022735) |
Enumeration Date | 2016-10-11 |
Last Update Date | 2024-10-08 |