| NPI | 1083208631 |
|---|---|
| Former Name | NICHOLE FENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21029) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 13408) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2024-08-26 |