| NPI | 1992374607 |
|---|---|
| Former Name | LAUREN BASYE |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1349826) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-12-20 |