| NPI | 1992159131 |
|---|---|
| Former Name | ANDREA SUSANNE WEBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 087862) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 13431) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2019-05-15 |