| NPI | 1063538031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: IL 056.011337) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT 14154) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: GA 1539) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NC 3331) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: NBCOT992514) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-02-22 |