Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 17065 | MD |
NPI | 1316188931 |
---|---|
Provider Name | Kathryn Kominski Aitken |
First Address | Rockville, MD 20853-3807 |
Second Address | Kensington, MD 20895-3434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2009 |
Last Update Date | 11/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17065 | PHYSICAL THERAPY LICENSE NUMBER (01) | MD |