| NPI | 1487746608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT 5493) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT 5493) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2019-02-25 |