| NPI | 1831688043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 398201) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 118999) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-22 |