| NPI | 1609289909 |
|---|---|
| Former Name | KIMBERLY MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016766) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2018-03-09 |