| NPI | 1447674254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: UT 13279117-4201) |
| Additional Taxonomies | 251B00000X Case Management (Licence: UT 13279117-4201) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2025-12-02 |