| NPI | 1477932598 |
|---|---|
| Former Name | KRISTINA LUCZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MO 2011030847) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2011030847) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2023-12-18 |