| NPI | 1982197059 |
|---|---|
| Former Name | BETHANY SUSANNE HOESCHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA 070502037) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |