| NPI | 1821260027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119008653) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC009796) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2021-12-28 |