| NPI | 1487514741 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2025-11-17 |
| Last Update Date | 2026-01-13 |