| NPI | 1639162357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 2491) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 2491) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2025-03-19 |