NPI | 1942409149 |
---|---|
Former Name | VICTORIA DIMONT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171W00000X Contractor (Licence: NY 032969) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT15239) |
Enumeration Date | 2007-07-17 |
Last Update Date | 2010-10-13 |