NPI | 1053405639 |
---|---|
Former Name | ANGELA ELAINE VALDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 2529) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: OK 2529) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2020-07-22 |