| NPI | 1194107037 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA11654) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CT 03237158) |
| 224Z00000X Occupational Therapy Assistant (Licence: NJ 46TA09096000) | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2015-06-27 |