| NPI | 1316916364 |
|---|---|
| Former Name | LISA MARIE KNAKIEWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: IL 070-014318) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096-002104) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-12-10 |