NPI | 1912462862 |
---|---|
Former Name | BAILEY ELIZABETH KOCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P22075) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WV 004075) |
Enumeration Date | 2019-02-05 |
Last Update Date | 2023-09-05 |