| NPI | 1871538454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT9735) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201005173) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2023-03-14 |