| NPI | 1003350125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT18043) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT3271) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |