NPI | 1003109943 |
---|---|
Former Name | MAGGIE LYNN HENJUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8777) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2011-05-25 |
Last Update Date | 2021-06-21 |