| NPI | 1225670078 |
|---|---|
| Former Name | AMANDA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT292994) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 16023) |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2022-07-11 |