| NPI | 1033455027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT006093) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC012643) |
| 225X00000X Occupational Therapist (Licence: DE U1-0001457) | |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2015-03-04 |