| NPI | 1588030449 |
|---|---|
| Former Name | KAITLYN BRUINIUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11159) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021589) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2021-12-02 |