| NPI | 1073827085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN OT2434) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AR OTR1986) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-02 |