| NPI | 1033134473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XE0001X Occupational Therapist, Environmental Modification (Licence: NC 6193) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 3366) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-07-20 |