NPI | 1760096077 |
---|---|
Former Name | TAYLOR L WISKUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 099278) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 70025037) |
Enumeration Date | 2020-09-03 |
Last Update Date | 2023-07-07 |