| NPI | 1427729060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201011118) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT22347) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2022-07-14 |