NPI | 1447919600 |
---|---|
Former Name | BRIANNA MICHAELS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 048140) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 048140-01) |
Enumeration Date | 2021-12-14 |
Last Update Date | 2024-11-14 |