| NPI | 1568895928 |
|---|---|
| Former Name | ALICIA JEAN BURILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21382) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0361401) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2025-04-25 |