NPI | 1174921449 |
---|---|
Former Name | VICTORIA LYNN MARTINEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019755) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2014-12-18 |
Last Update Date | 2021-01-28 |