| NPI | 1356693089 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT2821) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 011954-1) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2015-10-29 |