| NPI | 1235632704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201003810) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-12 |