| NPI | 1831723121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA 60995386) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-03-09 |