NPI | 1487004115 |
---|---|
Former Name | BLAIR LOSAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC p16343) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3579) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2022-03-02 |