| NPI | 1558984989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 106409) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.013553) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2021-03-03 |