| NPI | 1609485366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 2755) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 008119) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2022-04-01 |