| NPI | 1881032845 |
|---|---|
| Former Name | WENDY SUE BLOOM |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 8276) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2013-06-11 |