| NPI | 1124913744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 26260) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL 26260) |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-06-12 |