| NPI | 1558967646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT21347) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-12-05 |
| Last Update Date | 2024-10-11 |