| NPI | 1407527534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 21747) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 22082) |
| 225X00000X Occupational Therapist (Licence: WA 61130675) | |
| 225X00000X Occupational Therapist (Licence: TX 121432) | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |