| NPI | 1932882057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ME OT4548) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ME TO4511) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-10-18 |