NPI | 1396483939 |
---|---|
Former Name | KYLIE BEHRENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 112595) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
Enumeration Date | 2022-05-24 |
Last Update Date | 2023-07-20 |