| NPI | 1598413684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL 4171) |
| Additional Taxonomies | 225XL0004X Occupational Therapist Low Vision (Licence: AL 4171) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-03-25 |