Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1295949097 |
---|---|
Provider Name | Monique Marie Knoroski Dickinson |
First Address | San Diego, CA 92106-1807 |
Second Address | San Diego, CA 92106-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/07/2007 |