| NPI | 1861449183 |
|---|---|
| Former Name | BRENDA CAVANAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 19648) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2019-02-04 |