| NPI | 1194155929 |
|---|---|
| Former Name | KRISTINE LASSEN NEVANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 6801) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2022-04-07 |