| NPI | 1477250181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC019050) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119009824) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-04-27 |