| NPI | 1053334953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR1534) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR 1039824) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-11-12 |