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 |