| NPI | 1265771992 |
|---|---|
| Former Name | MARY GAGSTETTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-9281) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070019592) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2015-08-24 |