| NPI | 1407604838 |
|---|---|
| Former Name | SHEENA MARIE BURGOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IL 160006462) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160.006462) |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-09 |