| NPI | 1386172286 |
|---|---|
| Former Name | SAVANNAH ROSE BUBIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026007) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305211095) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-02-28 |