| NPI | 1952454639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-006446) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WA OT00002084) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2025-01-27 |