| NPI | 1386043032 |
|---|---|
| Former Name | SUSAN E DAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0004070) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023871) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2024-10-22 |