| NPI | 1851768303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: AR OT2023-028) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AR OT-A1000) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2023-10-04 |