NPI | 1962629998 |
---|---|
Former Name | ANGELA T. MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2009027345) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-02529) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2022-08-05 |