| NPI | 1528860855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XM0800X Occupational Therapist Mental Health | |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-06-10 |