| NPI | 1265870695 |
|---|---|
| Former Name | STACEY ANNE MORRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: IL 036146120) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125-063353) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2020-10-25 |