| NPI | 1164005930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 17-03887) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2021019020) |
| 225X00000X Occupational Therapist (Licence: MO 2021028199) | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-09-17 |