| NPI | 1063659282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: NY 011348-1) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: NY 011348-1) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |