NPI | 1194263509 |
---|---|
Former Name | TAYLOR BRANDENBURG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 085633) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 075155) |
Enumeration Date | 2017-02-06 |
Last Update Date | 2022-07-21 |