| NPI | 1346466604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 6026) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: RI OT00706) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |