| NPI | 1750412193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: UT 314601-4201) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-02-15 |