| NPI | 1336905942 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA OTL15381) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: MA OTA4645) |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-08-16 |