| NPI | 1912098799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: AL 2502) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AL 2502) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-05-08 |