| NPI | 1144412511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: GA OT005915) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TN 3709) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2014-09-15 |