| NPI | 1811319072 |
|---|---|
| Former Name | TIFFANY MARINOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 40813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 3223) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2018-03-17 |