| NPI | 1083264089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2377) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: UT 14049052-4201) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2026-04-06 |