NPI | 1649360389 |
---|---|
Former Name | SHAWNA R MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT1662) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 1662) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2022-03-10 |