| NPI | 1366724353 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2011025375) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS T-03054) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |