| NPI | 1700138088 |
|---|---|
| Former Name | ODESSA A QUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021965) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23938) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2019-04-02 |