| NPI | 1336417484 |
|---|---|
| Former Name | HEATHER RAE RISOVI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1321) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6950) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |