| NPI | 1093923864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT.006728) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WV 1318) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |