| NPI | 1063925352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XL0004X Occupational Therapist, Low Vision (Licence: NC 10943) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC 10943) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |