| NPI | 1033669213 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2018-09-05 |