| NPI | 1821134669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NM OT1147) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM 1147) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-06-03 |