| NPI | 1710152731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 07337) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT5911) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2024-10-07 |