| NPI | 1235238809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT524) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: ID OT524) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |