| NPI | 1619212941 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 4259) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: CT 001152) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2014-06-14 |