| NPI | 1881816304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT-831) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID OTLP240) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-05-24 |