| NPI | 1558495242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 4030) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 002709) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2023-07-17 |