| NPI | 1629480710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 07155) |
| Additional Taxonomies | 133N00000X Nutritionist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 235Z00000X Speech-Language Pathologist, | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 174H00000X Health Educator | |
| 224Y00000X Clinical Exercise Physiologist | |
| 225X00000X Occupational Therapist (Licence: DC 010000891) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2023-12-15 |