| NPI | 1336245711 |
|---|---|
| Former Name | ELAINE MARGARET ROGERS FANUCCHI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009788) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT20704) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2024-11-20 |