NPI | 1811296379 |
---|---|
Former Name | REBECCA RENEE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2023-01518) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 8438009-1204) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-03-23 |
Last Update Date | 2023-09-25 |