| NPI | 1518697531 |
|---|---|
| Former Name | DESTINY SANDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO CP008850T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6089) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-08-04 |