NPI | 1417109638 |
---|---|
Former Name | BROOKE SYSLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CT 010348) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 026547-1) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2024-12-23 |