| NPI | 1811412786 |
|---|---|
| Former Name | SAMANTHA KATHRYN MANNISTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14937-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 10403004-2401) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-10-26 |