| NPI | 1598125692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 07863) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC OT010001662) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2019-08-07 |