| NPI | 1598246472 |
|---|---|
| Former Name | JACQUELINE WENONA ANGERBAUER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR 4330) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OK 2386) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2023-06-15 |