NPI | 1265988174 |
---|---|
Former Name | CHRISTINE GUSTAFSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: PA OC012891) |
Additional Taxonomies | 225XH1200X Occupational Therapist Hand (Licence: PA OC012891) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2019-06-06 |