| NPI | 1730556366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT-958) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID OT958) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2024-01-23 |