| NPI | 1093334732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119008514) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC 010001734) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2022-08-19 |