| NPI | 1093011025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 09-0198) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 2534) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2024-02-07 |