| NPI | 1700881133 |
|---|---|
| Former Name | JENNIFER MARIE FABRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 04964) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4135) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2022-09-14 |