| NPI | 1902358948 |
|---|---|
| Former Name | DIANA MARIE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1105456) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2016038203) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2024-03-08 |