NPI | 1073094546 |
---|---|
Former Name | TINA VALENZUELA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1349645) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 33871) |
225100000X Physical Therapist (Licence: FL PT33871) | |
Enumeration Date | 2018-08-23 |
Last Update Date | 2021-10-18 |