| NPI | 1962246462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31008403A) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 520103665) |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2025-06-05 |