NPI | 1548224165 |
---|---|
Former Name | JENNIFER LYNN BORSETH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501005417) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5501005417) |
Enumeration Date | 2006-04-12 |
Last Update Date | 2022-07-21 |