| NPI | 1790971232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 002826) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MO 002826) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2025-03-17 |