| NPI | 1316531288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 5466) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT15930) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-11-19 |