| NPI | 1003256199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD 07076) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 016890) |
| 225X00000X Occupational Therapist (Licence: TX 113566) | |
| 225X00000X Occupational Therapist (Licence: CA 12397) | |
| 225X00000X Occupational Therapist (Licence: DC 010000929) | |
| 225X00000X Occupational Therapist (Licence: FL OT22590) | |
| 225X00000X Occupational Therapist (Licence: MI 5201012685) | |
| 225X00000X Occupational Therapist (Licence: MA 13901) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2022-05-12 |