| NPI | 1245548007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT14752) |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: IL 273161) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2024-06-11 |