Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 19985 | MD |
NPI | 1104442128 |
---|---|
Provider Name | Nicole Sanchez |
First Address | Baltimore, MD 21209-4596 |
Second Address | Baltimore, MD 21209-4596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2020 |
Last Update Date | 25/06/2020 |