| NPI | 1114525276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XM0800X Occupational Therapist, Mental Health |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |