| NPI | 1174418388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 16519) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 6771) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-09 |