| NPI | 1649384587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT-4694) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL OT-4694) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-10-04 |