NPI | 1417274689 |
---|---|
Former Name | KELLY LORAINE DAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: VA 0101273373) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101273373) |
208100000X Physical Medicine & Rehabilitation (Licence: DC 185401) | |
2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: WA FE60464961) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-04-28 |
Last Update Date | 2022-04-13 |