| NPI | 1437604766 |
|---|---|
| Former Name | BREANNE KATHRYN DUSEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22542) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT03461) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2022-10-21 |