| NPI | 1043732514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: FL OT24976) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT006296) |
| Enumeration Date | 2017-07-16 |
| Last Update Date | 2024-06-09 |