NPI | 1659785483 |
---|---|
Former Name | KATIE M FAST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KS 04-41199) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2014019433) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2018-10-18 |