NPI | 1558007641 |
---|---|
Former Name | ELLEN MUNDIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16059) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1360228) |
Enumeration Date | 2022-05-11 |
Last Update Date | 2024-12-04 |