| NPI | 1669209532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT-2592) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: ID OT-2592) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |