| NPI | 1902688203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AL 4716) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT24597) |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2023-10-20 |