NPI | 1700165057 |
---|---|
Former Name | EMILY BJORNDAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19959) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 26510) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2021-02-01 |