| NPI | 1336419480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MD 06777) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: DE U1-0000124) |
| 225X00000X Occupational Therapist (Licence: PA OC002115L) | |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |