| NPI | 1265863211 |
|---|---|
| Former Name | ELIZABETH R BOOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12545) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2018-02-13 |