NPI | 1457959710 |
---|---|
Former Name | MADISON ALEXANDRA FAKOURI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: LA 332852) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 121234) |
225XP0200X Occupational Therapist, Pediatrics (Licence: TX 121234) | |
Enumeration Date | 2020-10-09 |
Last Update Date | 2024-02-29 |