| NPI | 1508348996 |
|---|---|
| Former Name | JASMYNE THEUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 12218) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2020-04-16 |