NPI | 1124485404 |
---|---|
Former Name | GWEN RUTKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NJ 46TR01167500) |
Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131001487) |
Enumeration Date | 2016-01-18 |
Last Update Date | 2024-02-29 |