| NPI | 1982819421 |
|---|---|
| Former Name | TATYANA KHAZANOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0066080) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MD D0066080) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-01-18 |