| NPI | 1275933806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: R5688) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: KY R5688) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2024-08-19 |