| NPI | 1679162531 |
|---|---|
| Former Name | SHANEL SANDRA BOSANIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 6576) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AL 5233) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |