| NPI | 1053987560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 13954) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT61195339) |
| 225X00000X Occupational Therapist (Licence: AR OTR3521) | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2022-03-15 |