Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT26030 | CA |
NPI | 1770006181 |
---|---|
Provider Name | Monica Enughalu Egbuonu |
First Address | Downey, CA 90242-3456 |
Second Address | Downey, CA 90242-3456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2017 |
Last Update Date | 18/07/2017 |