| NPI | 1952706996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR2727) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2014035667) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2021-02-06 |