| NPI | 1285172841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2211) |
| Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: UT 10241270-4201) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2025-04-28 |