NPI | 1902046717 |
---|---|
Former Name | LEILA DIANNE MASON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1157685) |
Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: TX 1157685) |
Enumeration Date | 2009-03-06 |
Last Update Date | 2025-08-01 |