| NPI | 1689008963 |
|---|---|
| Former Name | KATHERINE DEJESUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 26913) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT02627) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2023-10-13 |