| NPI | 1538355532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: ID OT-843) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00003463) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2012-07-03 |