| NPI | 1811553472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 08448) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC 0T010001475) |
| Enumeration Date | 2019-05-18 |
| Last Update Date | 2019-05-18 |