| NPI | 1659890978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 08739) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119007440) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2020-11-24 |