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 |