| NPI | 1275933400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 5028) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC OT5028) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2026-02-19 |