| NPI | 1679739403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT010000506) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119004724) |
| 225X00000X Occupational Therapist (Licence: GA 006831) | |
| 225X00000X Occupational Therapist (Licence: FL 18487) | |
| 225X00000X Occupational Therapist (Licence: NY 029843-01) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2025-08-11 |