| NPI | 1417963240 |
|---|---|
| Former Name | CHRISTINA MARIE GORMASTIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 004448) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 004448) |
| 225100000X Physical Therapist (Licence: IN 05008800A) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-12-02 |