NPI | 1780140467 |
---|---|
Former Name | LEAH FAITH FIFELSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35430) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1312434) |
Enumeration Date | 2019-02-18 |
Last Update Date | 2022-01-17 |