| NPI | 1639553910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 444409) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IA 000932) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2021-03-09 |