| NPI | 1609498005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT011051) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 432219) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |