| NPI | 1871037846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| Enumeration Date | 2016-12-11 |
| Last Update Date | 2021-06-10 |