| NPI | 1174070742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 0000005048) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: GA OT001052) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2024-10-28 |