| NPI | 1790115962 |
|---|---|
| Former Name | KATIBETH ANN MOL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011875) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7206) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2020-03-27 |