| NPI | 1376336768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 225XR0403X Occupational Therapist Driving and Community Mobility |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |