NPI | 1699292961 |
---|---|
Former Name | MOLLY CORNELISSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01740300) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6280) |
Enumeration Date | 2017-08-27 |
Last Update Date | 2024-02-07 |