| NPI | 1780724856 |
|---|---|
| Former Name | SAMANTHA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT33588) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6734) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2018-07-17 |