| NPI | 1952862724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT011735) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NM 4052) |
| 225X00000X Occupational Therapist (Licence: TX 119533) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-05-05 |