NPI | 1467950279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA 23737) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-01-26 |
Last Update Date | 2022-07-28 |