| NPI | 1316249295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201007920) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2010-11-26 |
| Last Update Date | 2019-07-03 |