| NPI | 1114081569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT-242) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: ID OT-242) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: ID OT-242) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2024-09-24 |