| NPI | 1235462847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY R4352) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31005009A) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2012-02-16 |