| NPI | 1023479839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 19447) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NM 3498) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2022-03-11 |