NPI | 1700033636 |
---|---|
Former Name | WENNIE MAE BENITO ORMIDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT25149) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010278) |
225100000X Physical Therapist (Licence: MO 2006002061) | |
Enumeration Date | 2008-08-21 |
Last Update Date | 2016-08-09 |