NPI | 1235517251 |
---|---|
Former Name | SUSAN C GRAHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 61174149) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT006411) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2022-10-13 |