| NPI | 1992810386 |
|---|---|
| Former Name | JENNIFER PANOPIO BANICO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 29150) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 5402) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |