| NPI | 1437786316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2898) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ OTH-008082) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2022-05-09 |