| NPI | 1821745175 |
|---|---|
| Former Name | KRISTA L GOTTWALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-027080) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-11-17 |