NPI | 1982034377 |
---|---|
Former Name | DANIELLE BRODERICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02789) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 9968) |
Enumeration Date | 2013-11-21 |
Last Update Date | 2016-12-22 |