| NPI | 1073857934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: OH OT5850) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: PA OC003085L) |
| 225XG0600X Occupational Therapist, Gerontology (Licence: OH OT5850) | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: PA OC003085L) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |