| NPI | 1710475371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: DC OT100000168) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 05212) |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: DE U1-0001511) | |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2020-02-13 |