| NPI | 1366671620 |
|---|---|
| Former Name | NICOLE A MOUNDROS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018277) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305207304) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2017-12-20 |