| NPI | 1356099238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT200001307) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 09630) |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2024-01-04 |