| NPI | 1336807908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 14516) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC OT.6371OT) |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2023-08-14 |