NPI | 1518121193 |
---|---|
Former Name | ELIZABETH ALICE MINER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: LA 07431R) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1175918) |
Enumeration Date | 2008-07-14 |
Last Update Date | 2013-01-23 |