| NPI | 1053854414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119-007727) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA Oc014834) |
| 225X00000X Occupational Therapist (Licence: CA OT18120) | |
| 225X00000X Occupational Therapist (Licence: IN 31006597A) | |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2018-05-04 |