NPI | 1427044189 |
---|---|
Former Name | KRISTINE BOMEDIANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213251) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21032) |
Enumeration Date | 2005-09-27 |
Last Update Date | 2019-10-25 |