| NPI | 1790806156 |
|---|---|
| Former Name | DAWN MARIE KISSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1296763) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2007018567) |
| 225100000X Physical Therapist (Licence: KS 11-03614) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2023-11-08 |