| NPI | 1114327525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR2811) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA TOC102958) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2018-08-16 |