| NPI | 1356726434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ OTH-006694) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201008278) |
| 225X00000X Occupational Therapist (Licence: NV 15-0587) | |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2018-11-09 |