NPI | 1982024808 |
---|---|
Former Name | KELLI MARIE BUERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10284) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 2501) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2022-01-04 |