NPI | 1215583380 |
---|---|
Former Name | CHRISTINA AMANDA PENALBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61032123) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 297183) |
Enumeration Date | 2019-08-14 |
Last Update Date | 2023-08-04 |