| NPI | 1922498443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: OK 1942) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: OK 986) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |