| NPI | 1649713017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 008151) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AZ 6925) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2022-07-26 |