| NPI | 1447660238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC OT9660) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 5918) |
| 225X00000X Occupational Therapist (Licence: FL OT20866) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2022-02-16 |