| NPI | 1831817923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XM0800X Occupational Therapist Mental Health |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| 225XP0200X Occupational Therapist Pediatrics | |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |