| NPI | 1154751824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT.008488) |
| Additional Taxonomies | 225XG0600X Occupational Therapist Gerontology (Licence: OH OT.008488) |
| 225XP0200X Occupational Therapist Pediatrics (Licence: OH OT.008488) | |
| Enumeration Date | 2013-11-17 |
| Last Update Date | 2013-11-17 |