| NPI | 1558633826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 95704) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 3864) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2026-01-21 |