| NPI | 1396185559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY R4377) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY 122995) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2022-09-16 |