NPI | 1366817652 |
---|---|
Former Name | VICTORIA LEIGH WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039678) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02116500) |
Enumeration Date | 2015-12-11 |
Last Update Date | 2024-12-03 |