| NPI | 1962795021 |
|---|---|
| Former Name | JACQUELINE FLIESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11733) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-12-05 |