| NPI | 1760882856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1685) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225X00000X Occupational Therapist (Licence: SD 0816) | |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2020-08-03 |