| NPI | 1902349517 |
|---|---|
| Former Name | AMANDA GOSSELIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400129223) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22519) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2021-02-12 |