| NPI | 1699366245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201010867) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: 5201010867) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2021-02-02 |