| NPI | 1528711405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: KS 17-1528) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-02-02 |