| NPI | 1285841783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT8785) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 00008785) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-10-24 |