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 |