| NPI | 1932116597 |
|---|---|
| Former Name | PAMELA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 008106) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17571) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-02-01 |