NPI | 1649775669 |
---|---|
Former Name | SARAH MARIE MORTENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018110) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2018-03-30 |
Last Update Date | 2025-03-04 |