| NPI | 1649837857 |
|---|---|
| Former Name | DANIELLE MARIE REYSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: WI 111) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: WI 3348) |
| 247200000X Technician, Other (Licence: WI 545) | |
| 2472E0500X Technician, Other, EEG (Licence: WI 3348) | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-05-22 |