| NPI | 1548771389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19227) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC 11254) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2024-05-16 |