| NPI | 1629425418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT19218) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 6589) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2019-01-15 |