| NPI | 1922894096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 17939) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-09-05 |