| NPI | 1154758316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0005773) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NH 1297) |
| 225X00000X Occupational Therapist (Licence: MA 6558) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2025-08-20 |