| NPI | 1811624422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 17-03127) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2013020033) |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2022-08-03 |