| NPI | 1093206989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-007917) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO OT.0004959) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2019-11-22 |