| NPI | 1184260473 |
|---|---|
| Former Name | AUTUMN HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045174) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2023-02-14 |