| NPI | 1346996543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 22742) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT22742) |
| 225X00000X Occupational Therapist (Licence: TX 122443) | |
| 225X00000X Occupational Therapist (Licence: KY 275977) | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-02-25 |