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 |