| NPI | 1164085239 |
|---|---|
| Former Name | KATIE MARIE JORISSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2244) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10285) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |