| NPI | 1285906826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 10315) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 12267) |
| Enumeration Date | 2012-01-28 |
| Last Update Date | 2012-01-28 |