NPI | 1265702864 |
---|---|
Former Name | SAMANTHA WIECHMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029109) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070018996) |
Enumeration Date | 2012-01-12 |
Last Update Date | 2020-12-11 |