| NPI | 1194458703 |
|---|---|
| Former Name | TIFFANY SAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL89607) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO CP038715T) |
| 225100000X Physical Therapist (Licence: WA CP049787T) | |
| 225100000X Physical Therapist (Licence: MD 29136) | |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2026-05-28 |