| NPI | 1336807098 |
|---|---|
| Former Name | HAZEL LAGROSAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA18845) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA17726) |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |