NPI | 1366798282 |
---|---|
Former Name | MEGAN ANNE GAVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207457) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24253) |
Enumeration Date | 2012-07-29 |
Last Update Date | 2013-11-19 |