| NPI | 1285078840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY R5546) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31007089A) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2023-08-03 |