| NPI | 1427692284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 13597) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2021-03-04 |