| NPI | 1598249369 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: MO 2022007934) | |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2023-08-21 |