| NPI | 1023575065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: WI 6456-26) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: WI 6456-26) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2021-12-28 |