| NPI | 1033545173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 18-0097) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: KS T-03741) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2021-05-27 |