| NPI | 1952817561 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 2023016977)  | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056015810)  | 
| Enumeration Date | 2017-12-19 | 
| Last Update Date | 2023-12-12 |