| NPI | 1164130894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT23667) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT008831) |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2023-05-08 |