| NPI | 1831193796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN 361) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TN OT00361) |
| 225X00000X Occupational Therapist (Licence: VA 0119001450) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-01-19 |