NPI | 1689221392 |
---|---|
Former Name | ALYSSA MARIE JANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT298952) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2019-08-19 |
Last Update Date | 2022-12-07 |