| NPI | 1649764556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 08500) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XM0800X Occupational Therapist, Mental Health | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-02-22 |