| NPI | 1740759349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 08644) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119007931) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-08-07 |