| NPI | 1619948403 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 04913) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2018-12-07 |