| NPI | 1336777846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 8994) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 6823) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-03-03 |