| NPI | 1255355780 |
|---|---|
| Former Name | NICOLE SUZANNE KIRN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05004492A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070008573) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-11-27 |