| NPI | 1497082630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2012005417) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-02788) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2020-08-11 |