NPI | 1699178533 |
---|---|
Former Name | JULIA J CHARLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11454) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS CP004479T) |
Enumeration Date | 2014-10-07 |
Last Update Date | 2021-08-30 |