NPI | 1043448814 |
---|---|
Former Name | JACKLIN MATKOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 35605) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35605) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2025-04-29 |