| NPI | 1710341292 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: ME 3369) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 12224) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: CT 4757) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-12-21 |