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 |