| NPI | 1073718987 |
|---|---|
| Former Name | JENNIFER JEAN FERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT23458) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2021-11-28 |