| NPI | 1447823117 | 
|---|---|
| Former Name | KARISSA A HANSEN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 12980) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 106901) | 
| Enumeration Date | 2021-07-21 | 
| Last Update Date | 2023-05-18 |