NPI | 1457842155 |
---|---|
Former Name | LAUREN MICHELLE LAGRO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0015896) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTLP.0000122) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2018-11-02 |