Individual
GILDA ENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1103776
KS
225100000X
Physical Therapist
Primary
2006038050
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K02-27-4036
DRIVER'S LICENSE
KS
Enumeration date
11/17/2016
Last updated
11/17/2016
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