NPI | 1225221864 |
---|---|
Former Name | TRACY B O'MARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA C140275) |
Additional Taxonomies | 208D00000X General Practice (Licence: WI 50822-020) |
Enumeration Date | 2007-08-27 |
Last Update Date | 2018-11-28 |