| NPI | 1225460579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA 60714537) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: LA OTT.200664) |
| 225X00000X Occupational Therapist (Licence: MT 60714537) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2018-04-17 |