| NPI | 1245363472 |
|---|---|
| Former Name | CRYSTAL ANN HERZBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 8350) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10441) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-08-30 |