| NPI | 1437722329 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225X00000X Occupational Therapist | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 21985) | 
| Enumeration Date | 2021-07-20 | 
| Last Update Date | 2024-09-20 |