NPI | 1861708869 |
---|---|
Former Name | ASHLEY LAUREN GAUGHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3035) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.017945) |
Enumeration Date | 2010-08-27 |
Last Update Date | 2021-02-25 |