| NPI | 1598962409 |
|---|---|
| Former Name | ANDREA LYNN QUANDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MI 5101017363) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101017363) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-11-16 |