| NPI | 1558139881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2023005704) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 17-04123) |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2023-12-15 |