| 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 |