| NPI | 1336494723 |
|---|---|
| Former Name | JENNIFER ANNA PHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60612231) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT39197) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2023-10-05 |