| NPI | 1255994000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 8754-26) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.004901) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2024-11-26 |