| NPI | 1457303695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: ND 612) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ND 612) |
| 225XN1300X Occupational Therapist Neurorehabilitation (Licence: ND 612) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-08-07 |