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 |