| NPI | 1164950994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MA 11875) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2023-06-21 |