| NPI | 1740744515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2019027180) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2022-09-08 |