| NPI | 1962641118 |
|---|---|
| Former Name | MELISSA JUNE N LICUPA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009769A) |
| Additional Taxonomies | 171W00000X Contractor (Licence: IN 05009769A) |
| 171W00000X Contractor (Licence: MD 21483) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2025-03-10 |