| NPI | 1871852020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT21471) |
| Additional Taxonomies | 174400000X Specialist |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2021-10-18 |