| NPI | 1609610609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO 0008030) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID 9671360) |
| 225X00000X Occupational Therapist (Licence: WY OT-1806) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-07-29 |