| NPI | 1356949200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ME OT-1175) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2024-05-02 |