| NPI | 1164091203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 16516) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 6937) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2025-02-24 |