| NPI | 1932713450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AK 165518) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AK 165518) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-09 |