NPI | 1760436901 |
---|---|
Former Name | KARA L GUMMOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-014426) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03789) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2012-04-12 |