NPI | 1053849026 |
---|---|
Former Name | KRISTEN SUE WENDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10889) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: SD 1994) |
Enumeration Date | 2017-06-02 |
Last Update Date | 2022-06-14 |