| NPI | 1255619649 |
|---|---|
| Former Name | MARY CLAIRE DAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 8939) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070020318) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2018-07-12 |