| NPI | 1861009425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119008060) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC OT010001613) |
| 225X00000X Occupational Therapist (Licence: MD 08800) | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-07-01 |