| NPI | 1710127105 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NM 2547) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 109318) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-02-25 |