| NPI | 1013346139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 2368) |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: CA 2368) | |
| 302R00000X Health Maintenance Organization (Licence: CA 2368) | |
| 305R00000X Preferred Provider Organization (Licence: CA 2368) | |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |