NPI | 1861276768 |
---|---|
Former Name | JORDYN LEIGH GRABOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4558) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NE 4558) |
Enumeration Date | 2023-08-22 |
Last Update Date | 2023-12-19 |