NPI | 1477672095 |
---|---|
Former Name | JILL SUSANNE GIBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT36639) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P14505) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2014-06-24 |