NPI | 1427382720 |
---|---|
Former Name | AMANDA GWEN HAYES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 12352) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC 12352) |
Enumeration Date | 2009-09-21 |
Last Update Date | 2018-11-16 |