| NPI | 1326425992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NM OT22031) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OK 1912) |
| 225X00000X Occupational Therapist (Licence: WA 61296329) | |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2022-12-23 |