| NPI | 1316583347 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 5274) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 024161) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |