| NPI | 1568694123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2019037835) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 3410) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2020-11-02 |