| NPI | 1245739846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201011018) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2020-10-19 |