NPI | 1821256413 |
---|---|
Former Name | MARSA GENANN MOODY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0062534) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A120971) |
Enumeration Date | 2008-05-30 |
Last Update Date | 2021-06-04 |