| NPI | 1386122562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WI 21246) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 402487) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2023-02-09 |