NPI | 1356425714 |
---|---|
Former Name | VIKKI MICHELE FARIAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1140945) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1140945) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2011-12-29 |