NPI | 1346664448 |
---|---|
Former Name | GABRIELLE STAR CRIPPEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7288) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NC P14706) |
Enumeration Date | 2014-02-10 |
Last Update Date | 2015-06-11 |