| NPI | 1881297117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MT OTP-OT-LIC-7693) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MT 7693) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2022-04-27 |