| NPI | 1760949465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 5093) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: RI OT01758) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |