| NPI | 1538770847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-2927) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ OTH-008227) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2023-06-26 |