| NPI | 1972722262 |
|---|---|
| Former Name | ANGELIQUE RENEE AUBUCHON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-001877) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 1424) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2022-02-07 |