NPI | 1144551482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: PA OC010507) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00188100) |
225XP0200X Occupational Therapist, Pediatrics (Licence: NJ 46TR00188100) | |
Enumeration Date | 2010-01-27 |
Last Update Date | 2012-04-04 |