| NPI | 1659852523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation |
| Additional Taxonomies | 225XN1300X Occupational Therapist Neurorehabilitation |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-08-28 |