NPI | 1780111336 |
---|---|
Former Name | MOLLY SLUSSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211051) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC P19671) |
Enumeration Date | 2017-05-15 |
Last Update Date | 2023-01-20 |