| NPI | 1235721093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 16044) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT007978) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2024-10-09 |