| NPI | 1619798733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XN1300X Occupational Therapist Neurorehabilitation |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-10-21 |