| NPI | 1508529447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT61309942) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.014535) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2022-07-11 |