| NPI | 1811481559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 395834) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: HI 1776) |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2020-02-26 |