| NPI | 1285876581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: HI 385) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: HI 385) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2009-04-01 |