NPI | 1265980304 |
---|---|
Former Name | DOMINIQUE NICOLE HARDAWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: MD 0119007097) |
Additional Taxonomies | 225X00000X Occupational Therapist |
Enumeration Date | 2016-09-19 |
Last Update Date | 2023-10-22 |