NPI | 1285013953 |
---|---|
Former Name | LISA J HAACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: WI 5827-24) |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: TN 7475) |
Enumeration Date | 2015-05-27 |
Last Update Date | 2015-11-16 |