| NPI | 1316236722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 12056) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NH 2601) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2017-02-16 |