| NPI | 1811361405 |
|---|---|
| Former Name | MARIESA RALENE BARBOSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT2023-2307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1268486) |
| 225100000X Physical Therapist (Licence: AZ LPT-30112) | |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2023-11-08 |