| NPI | 1336531482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT22996) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OTA14243) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2022-03-31 |