| NPI | 1548882152 |
|---|---|
| Former Name | MICHAELA NIEMEYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-025217) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 2227-39) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2022-03-25 |