| 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 |