NPI | 1881256477 |
---|---|
Former Name | KATE BUBOLTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 19179) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 2326) |
225100000X Physical Therapist (Licence: MN 11647) | |
Enumeration Date | 2019-07-03 |
Last Update Date | 2020-06-10 |