| NPI | 1770969081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NC 9789) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2019-05-29 |