| NPI | 1306386818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC014956) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 4740) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-23 |