| NPI | 1710754056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0002263) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: CO OT.0002263) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2024-04-03 |