| NPI | 1215036033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TN OT0000003621) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA OT 5031) |
| 225X00000X Occupational Therapist (Licence: AR OTR1219) | |
| 225X00000X Occupational Therapist (Licence: VA 0119004307) | |
| 225X00000X Occupational Therapist (Licence: TX 108485) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |