| NPI | 1336313832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OK 1602) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WY OT-756) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2022-07-21 |