| NPI | 1447576780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT1486) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT13883) |
| 225XM0800X Occupational Therapist, Mental Health (Licence: ME OT1486) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2021-10-28 |