| NPI | 1598878852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC014474) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 05701) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-05-22 |