| NPI | 1770565624 |
|---|---|
| Former Name | CARLA JANE ROODZANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2986) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID RPT719) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-11-08 |