| NPI | 1669704201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 7446) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ME OT3476) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2024-01-08 |