NPI | 1417402710 |
---|---|
Former Name | KAITLYN R ADAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044028-1) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22598) |
Enumeration Date | 2016-08-17 |
Last Update Date | 2019-02-18 |