| NPI | 1710862339 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 029435) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR01194400) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |