| NPI | 1679159701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT21705) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: FL OT21705) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT21705) | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-05-19 |