| NPI | 1366003642 |
|---|---|
| Former Name | SAMANTHA ROSKAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2022-11-01 |