| NPI | 1871386110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PR 713) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 3023) |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |