NPI | 1841850070 |
---|---|
Former Name | ANA JEAN HYDEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06247) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019021507) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2023-09-19 |