| NPI | 1144737594 |
|---|---|
| Former Name | TAYLOR MAYLEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MI 2601001411) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 3203054300) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |