| NPI | 1053436592 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT4487) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO 970184) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-10-04 |