| NPI | 1194615104 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 030129) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR01239500) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-07-09 |