| NPI | 1174857643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC011440) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: PA OC011440) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2015-02-12 |