| NPI | 1255749024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist, Physical Rehabilitation (Licence: ND 392) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-09-10 |