NPI | 1992740492 |
---|---|
Former Name | TARA M WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070011844) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2000146164) |
Enumeration Date | 2006-06-18 |
Last Update Date | 2010-01-26 |