| NPI | 1346843968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2020-11-17 |