| NPI | 1831618941 |
|---|---|
| Former Name | KAYLA MARIE MANSUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14030) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10920) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2021-01-15 |