| NPI | 1164492716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 978472) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ND 423) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2012-10-22 |