| NPI | 1174995757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: OH 007575) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: OH 007575) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |