| NPI | 1417457490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 18-1020) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: NV 18-1020) |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2022-10-20 |