| NPI | 1609842947 |
|---|---|
| Former Name | SUSAN JEANINE BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: LA 021783) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA 021783) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-12-30 |