| NPI | 1730641143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-007753) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 19682) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2023-10-03 |