NPI | 1710589494 |
---|---|
Former Name | SHENE ERICA HILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64886) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1323360) |
Enumeration Date | 2020-11-09 |
Last Update Date | 2023-08-01 |