| NPI | 1689208282 |
|---|---|
| Former Name | CONNIE CHEN BENTIVOLIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12523) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 16843) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2024-08-26 |