| NPI | 1063533305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 3996) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 104437) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |