| NPI | 1245293547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT1300) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL CHT1041100386) |
| 225X00000X Occupational Therapist (Licence: GA OT002267) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2007-07-08 |