| NPI | 1831410083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: ID OT-984) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2022-06-08 |