| NPI | 1427608116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19498) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 102994) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2021-12-12 |