| NPI | 1063790376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT12101) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056008951) |
| 225X00000X Occupational Therapist (Licence: CA 11895) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |