| NPI | 1255976023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT010001210) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-06-26 |