NPI | 1093123358 |
---|---|
Former Name | MARIE PEREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL19709) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT011526) |
Enumeration Date | 2014-07-30 |
Last Update Date | 2024-11-25 |