| NPI | 1396312344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT200001292) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 09423) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2022-08-05 |