| NPI | 1922437656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 05040) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DC OT010000831) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2020-02-19 |