| NPI | 1841565520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT15204) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 10274) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2024-03-06 |