| NPI | 1407107204 |
|---|---|
| Former Name | MARY MICHELLE LOQUIAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02019500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 5275) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2021-11-19 |