| NPI | 1437786647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 2987) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 120631) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2022-06-29 |