| NPI | 1942186341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-08-12 |