Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3589 | CA |
NPI | 1033281266 |
---|---|
Provider Name | Donna Banister |
First Address | Gilroy, CA 95021-2104 |
Second Address | Gilroy, CA 95020-5129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 09/06/2011 |