| NPI | 1629841598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 437059) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ OTH-008206) |
| 225X00000X Occupational Therapist (Licence: WA OT61484881) | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |