| NPI | 1447933734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: 13776) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 13776) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |