| NPI | 1023746716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 48.004623) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 025240-01) |
| 225X00000X Occupational Therapist (Licence: PA OC14995) | |
| 225X00000X Occupational Therapist (Licence: SC 5946) | |
| 225X00000X Occupational Therapist (Licence: CO OT.0006631) | |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2022-08-10 |