| NPI | 1871725200 |
|---|---|
| Former Name | MARY KATHLEEN FAUL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2009030562) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070017236) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2021-08-09 |