NPI | 1316187354 |
---|---|
Former Name | KATHLEEN GOUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013333) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-016937) |
Enumeration Date | 2009-03-04 |
Last Update Date | 2022-08-22 |