NPI | 1932638756 |
---|---|
Former Name | KENNIA ABIGAIL MERLOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT4808) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2017-06-06 |
Last Update Date | 2022-10-04 |