| NPI | 1235178468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC010309) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: PA OP003013L) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-09-11 |