| NPI | 1952869059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: NC 13386) |
| Additional Taxonomies | 225XF0002X Occupational Therapist Feeding, Eating & Swallowing |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2024-06-30 |