| NPI | 1518420397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: RI OT02013) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IA 096135) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2025-09-11 |