| NPI | 1013342997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119004727) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT11716) |
| 225XE0001X Occupational Therapist, Environmental Modification (Licence: VA 0119004727) | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: VA 0119004727) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: VA 0119004727) | |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |