| NPI | 1033349717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: NY 013877-1) |
| Additional Taxonomies | 225XH1300X Occupational Therapist, Human Factors (Licence: NY 013877-1) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2013-12-30 |