NPI | 1538639323 |
---|---|
Former Name | PATRICIA ANN KOOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017358) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5501017358) |
Enumeration Date | 2018-12-05 |
Last Update Date | 2019-08-27 |