| NPI | 1396421475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA 22249) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-06-23 |