| NPI | 1235610841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH 2088) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: OK 2088) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-23 |