NPI | 1194918714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: KS 17-00816) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-00816) |
Enumeration Date | 2007-08-27 |
Last Update Date | 2007-08-27 |