| NPI | 1992542252 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201013819) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 118790) |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |