| NPI | 1104854447 |
|---|---|
| Former Name | ELIZABETH PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11418-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 004787) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2013-08-04 |