| NPI | 1952330920 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT12312) | 
| Additional Taxonomies | 225X00000X Occupational Therapist | 
| Enumeration Date | 2006-07-02 | 
| Last Update Date | 2024-10-25 |