| NPI | 1053254557 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NM OT-2026-0104) |
| Enumeration Date | 2026-04-10 |
| Last Update Date | 2026-07-22 |