| 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 |