| NPI | 1255590543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: HI OT-585) |
| Additional Taxonomies | 225XE0001X Occupational Therapist Environmental Modification (Licence: HI OT-585) |
| 225XG0600X Occupational Therapist Gerontology (Licence: HI OT-585) | |
| 225XP0200X Occupational Therapist Pediatrics (Licence: HI OT-585) | |
| 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: HI OT-585) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2011-02-04 |