| NPI | 1306428743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XR0403X Occupational Therapist, Driving and Community Mobility |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2022-11-15 |