| NPI | 1871025478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 03248) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WV 833) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2024-02-16 |