| NPI | 1710550710 |
|---|---|
| Former Name | ELIZABETH CAROLINE LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT.61301593) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017573) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2022-06-22 |