| NPI | 1588079933 |
|---|---|
| Former Name | BRIANNA RADTKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: MN 3172) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: MN 981086) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2019-01-31 |