Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033594197 |
---|---|
Provider Name | Rosalina Gaspar-Montano |
First Address | Los Angeles, CA 90017-1466 |
Second Address | Los Angeles, CA 90017-1466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2015 |
Last Update Date | 30/07/2015 |