NPI | 1437698578 |
---|---|
Former Name | EMILY CLAIRE FONTAINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22336) |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: MA 22336) |
2251X0800X Physical Therapist, Orthopedic (Licence: MA 22336) | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2017-02-22 |