| NPI | 1659838720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 20534) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 19480) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2023-08-22 |