| NPI | 1417553785 |
|---|---|
| Other Name | KYLE PONCE JUREIDINI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 299639) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 299639) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2022-05-02 |