| NPI | 1225634470 |
|---|---|
| Former Name | LISA MARIE OLSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 019714) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2020-12-11 |