NPI | 1972057180 |
---|---|
Former Name | CIARRA MCGREGOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 16299) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 178539) |
Enumeration Date | 2016-08-05 |
Last Update Date | 2019-05-09 |