| NPI | 1407516867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PR 1359) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: PR 7225) |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2025-08-11 |