Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5346 | NC |
NPI | 1194010249 |
---|---|
Provider Name | Mutsuko Gonokami-Curia |
First Address | Winston Salem, NC 27106-3040 |
Second Address | Winston Salem, NC 27106-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 16/06/2011 |