| NPI | 1073818779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: MO 2010032131) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.003372) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2015-06-25 |