NPI | 1669010161 |
---|---|
Former Name | SHANTELLE IGIOZEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1344345) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 294861) |
Enumeration Date | 2019-12-15 |
Last Update Date | 2021-08-24 |