| NPI | 1245595065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT006614) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 114772) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2025-02-06 |