| NPI | 1841368768 |
|---|---|
| Other Name | LUCILLE MARIE LOPEZ WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT6997) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA AC3506) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2010-09-10 |