| NPI | 1225773930 |
|---|---|
| Former Name | GAIL WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OR 9741) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA-19954) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |