| NPI | 1861259202 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0008339) | 
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification | 
| 225XR0403X Occupational Therapist, Driving and Community Mobility (Licence: CO OT.0008339) | |
| Enumeration Date | 2024-03-04 | 
| Last Update Date | 2024-03-04 |