| NPI | 1295270122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 170907) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 3106244A) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2017-01-02 |