| NPI | 1063756443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID ot-688) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OR 1068103) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |