| NPI | 1548206790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 13-0387) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 5497) |
| 225X00000X Occupational Therapist (Licence: AZ 4987) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-12-20 |