| NPI | 1700356342 |
|---|---|
| Former Name | ODESSA GAJO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: LA A10128R) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 4357) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |