| NPI | 1700667359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT25370) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NV OT-3312) |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-07-04 |