| NPI | 1518337419 |
|---|---|
| Former Name | JILLIAN BALQUIEDRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.021934) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-07-07 |