| NPI | 1023656196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-007997) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 432061) |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2020-02-12 |