| NPI | 1184401721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-08 |