NPI | 1750770228 |
---|---|
Former Name | KAREN MARISSA KRAGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 4633) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036908-1) |
225100000X Physical Therapist (Licence: CA 37979) | |
Enumeration Date | 2015-01-21 |
Last Update Date | 2022-12-08 |