| NPI | 1144489840 |
|---|---|
| Former Name | GEZEL TAMAYO VILLANUEVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 010519-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00726200) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2014-09-23 |