NPI | 1457745705 |
---|---|
Former Name | COURTNEY DREW CAVANAUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: CA A172896) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A172896) |
Enumeration Date | 2015-03-25 |
Last Update Date | 2023-10-18 |