| NPI | 1740076611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: MD 529929) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD 529929) |
| 225X00000X Occupational Therapist (Licence: MD 529929) | |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-22 |