NPI | 1295112340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IA 101897) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-03060) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2020-10-12 |