| NPI | 1023450350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201006187) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 8557) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2025-09-03 |