| NPI | 1427381961 |
|---|---|
| Former Name | KATHLEEN SUSANNE BANNISTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23263) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031542) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2011-04-25 |