NPI | 1629258017 |
---|---|
Former Name | KATHLEEN MARIE BURNS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205211) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 020302369) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2021-03-09 |