| NPI | 1164732954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: OH 007132) |
| Additional Taxonomies | 225XE0001X Occupational Therapist, Environmental Modification (Licence: OH 007132) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |