| NPI | 1912764705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NH 3533) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 15045) |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-02-28 |