| NPI | 1720425143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 312221) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2021-02-12 |