| NPI | 1821365941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT005328) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2019-08-05 |