| NPI | 1861603599 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VT 0720000527) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 6808) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |