| NPI | 1093223182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TN 7758) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 224Z00000X Occupational Therapy Assistant (Licence: FL OTA16207) | |
| 225X00000X Occupational Therapist (Licence: FL OT22381) | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2025-05-19 |