| NPI | 1144794322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA 007748) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 13034) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2020-07-27 |