| NPI | 1649804824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT010001728) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: MD 08953) | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2021-03-09 |