| NPI | 1710578224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201013335) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 21469) |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-09-25 |