| NPI | 1487893384 |
|---|---|
| Former Name | JESSICA SARAH FATTAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CO 10776) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 029656-1) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 029656-1) | |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2010-12-17 |