| NPI | 1366910051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 245224) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056013142) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2020-01-06 |