| NPI | 1669767620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225800000X Recreation Therapist (Licence: MI 59426) |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |