| NPI | 1235471152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2009012407) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: KS 17-02467) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2024-04-11 |