| NPI | 1790206282 |
|---|---|
| Former Name | JANE MIKEL KINYOUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-2006) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 9647) |
| 225100000X Physical Therapist (Licence: MT 442-PT) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2017-07-05 |