| NPI | 1467046938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VT 072.0134172) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 6767) |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-03-10 |