| NPI | 1689142010 |
|---|---|
| Former Name | KARLIE MARIE ENNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215463) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-11-03 |
| Last Update Date | 2023-05-05 |