| NPI | 1619633401 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT4102) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 13707) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: ME OT4102) | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-07-16 |