| NPI | 1821835828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT009836) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OTR25378) |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2026-04-29 |