| NPI | 1689300816 |
|---|---|
| Former Name | FABIANA BASTOS SILVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2089557) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 3129659) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-12-20 |