| NPI | 1659679801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: CT 3790) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2021-03-12 |