| NPI | 1174249098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: UT 13708187-4201) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: ID OT-2586) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2025-11-18 |