NPI | 1396174017 |
---|---|
Former Name | DEANNA FAVERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT38897) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208347) |
225100000X Physical Therapist (Licence: DC PT871510) | |
Enumeration Date | 2013-11-04 |
Last Update Date | 2022-07-11 |