| NPI | 1902262702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XM0800X Occupational Therapist, Mental Health (Licence: AL 3536) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: AL 3536) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |