| NPI | 1154560878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XN1300X Occupational Therapist, Neurorehabilitation |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-24 |