| NPI | 1639688922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SD 1049) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SD 0479) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |