| NPI | 1275754541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 1018176) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119004211) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2024-04-25 |