| NPI | 1215293840 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: MS TA2665) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: LA OTA.200145) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |