| NPI | 1285851568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: VA 0119003742) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: VA 0119003742) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: VA 0119003742) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2015-11-17 |