| NPI | 1619511748 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WV C1919) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OH OTA004178) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |