NPI | 1730873894 |
---|---|
Former Name | CHRISTINE ANGELI JISON FERNANDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT-2023-2169) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2023-06-02 |
Last Update Date | 2023-10-25 |