NPI | 1407285034 |
---|---|
Former Name | JACQUELINE ANN KETTLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MI L2479280) |
Enumeration Date | 2013-11-04 |
Last Update Date | 2021-06-21 |