| NPI | 1518434661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19524) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119007881) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2018-10-26 |