| NPI | 1013379213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 344678) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 07920) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2021-08-08 |