| NPI | 1730830498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: MD 09005) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: NJ 46TR01081800) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2023-11-28 |