| NPI | 1891888749 |
|---|---|
| Former Name | NICOLE LINN DANIELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1887) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID PT-1887) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-04-04 |