| NPI | 1588278287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2020025192) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KS 1703743) |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-10-26 |