| NPI | 1770784191 |
|---|---|
| Former Name | ANGELA RENEE LIPSCOMB |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2011-00898) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125054432) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2021-04-27 |