| NPI | 1588329973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV OT-3029) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 22059) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2023-08-28 |