| NPI | 1164856530 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31005875A)  | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.010065)  | 
| Enumeration Date | 2013-08-21 | 
| Last Update Date | 2015-09-09 |