| NPI | 1528651759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 13874) |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2023-05-08 |