| NPI | 1184023285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DE U1-0001411) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00599200) |
| 225X00000X Occupational Therapist (Licence: NY 017652) | |
| 225X00000X Occupational Therapist (Licence: PA OC012563) | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |