| NPI | 1437362613 |
|---|---|
| Former Name | BONNIE FATEMI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WI 796-019) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 796-19) |
| 225200000X Physical Therapy Assistant (Licence: WI 796-19) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2019-03-07 |