| NPI | 1497419584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO OT.0007810) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 122013) |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2023-07-06 |