| NPI | 1518697812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XN1300X Occupational Therapist, Neurorehabilitation |
| Additional Taxonomies | 101Y00000X Counselor |
| 171400000X Health & Wellness Coach | |
| 174400000X Specialist | |
| 175F00000X Naturopath | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-06-07 |