| NPI | 1033840681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: UT 11565326-4201) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: UT 11565326-4201) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |