| NPI | 1811951254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC003939L) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC003939-L) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-01-31 |