| NPI | 1215122684 |
|---|---|
| Former Name | SHIRLEY DE TABALI DELOS SANTOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 018660) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2018-03-17 |