| NPI | 1386010767 |
|---|---|
| Former Name | KATHLEEN MARIE JOSEF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015027110) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 4258) |
| 225100000X Physical Therapist (Licence: OK 5234) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2020-05-29 |