| NPI | 1659816379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 359551) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2019-09-17 |