NPI | 1689629420 |
---|---|
Former Name | MICHELLE KOENIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 25343) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06993) |
225X00000X Occupational Therapist (Licence: LA 200099) | |
225X00000X Occupational Therapist (Licence: FL 14636) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2015-03-30 |