| NPI | 1710545777 |
|---|---|
| Former Name | AMANDA GUBBELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021014458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9707) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2023-08-24 |