| NPI | 1275765059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AR OTR1188) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 004276) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |