| NPI | 1336652569 |
|---|---|
| Former Name | BLANCA ANGELICA ULLOA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NM PTA0708) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NM A-0708) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2022-03-11 |