| NPI | 1639103609 |
|---|---|
| Former Name | WILFRED JASON TIA ATIENZA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME 116489) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A86516) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-11-15 |