| NPI | 1598267098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT007474) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AL 4643) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2020-10-08 |