NPI | 1275572661 |
---|---|
Former Name | KATHLEEN TAIBE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202695) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: 2305202695) |
Enumeration Date | 2006-06-04 |
Last Update Date | 2018-11-29 |