| NPI | 1578147500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IA 097598) |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation (Licence: IA 097598) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: IA 097598) | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-06 |