NPI | 1548676836 |
---|---|
Former Name | AMY LYNN DITTENHOFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: ND 34.013502) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 34.013502) |
Enumeration Date | 2014-07-07 |
Last Update Date | 2022-02-21 |