| NPI | 1336505734 |
|---|---|
| Former Name | SAMANTHA KATHERINE STADT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01956700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60575553) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2021-08-09 |