| NPI | 1265778005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DE U1-001358) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 104284) |
| 225X00000X Occupational Therapist (Licence: PA OC012508) | |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2013-09-04 |