| NPI | 1316449358 |
|---|---|
| Former Name | TIFFANY K IKEDA-SIMAO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-4520) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: HI PT-4520) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2022-05-03 |