| NPI | 1003268798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN OT 1818) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NC 13817) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2021-03-19 |