| NPI | 1043695638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19594) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 116625) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2023-01-24 |