| NPI | 1245765072 |
|---|---|
| Former Name | SIERRA JEANNE MAUCORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2111) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10280) |
| Enumeration Date | 2017-04-30 |
| Last Update Date | 2018-07-03 |