NPI | 1326465477 |
---|---|
Former Name | JACLYN GOROVOY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS14789) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 520595110) |
Enumeration Date | 2014-03-26 |
Last Update Date | 2018-03-17 |