| NPI | 1992048532 |
|---|---|
| Former Name | NICOLETTE HARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63655) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 38190) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2020-09-21 |