| NPI | 1053138156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT25558) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: NY 030104) |
| Enumeration Date | 2024-09-21 |
| Last Update Date | 2025-05-07 |