| NPI | 1881307999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 3568) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 6755) |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2025-02-20 |