| NPI | 1609592138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 15953) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 8076) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2024-04-09 |