| NPI | 1861541682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 120443) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NJ 46TR00003600) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-12-17 |