NPI | 1760533749 |
---|---|
Former Name | ROBERTA L JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 2899) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070012031) |
Enumeration Date | 2007-01-16 |
Last Update Date | 2023-10-24 |