Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2125 | NV |
NPI | 1275826448 |
---|---|
Provider Name | Deena Dia |
First Address | Henderson, NV 89014-3586 |
Second Address | Henderson, NV 89014-3586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2011 |
Last Update Date | 20/05/2011 |