| NPI | 1356742225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 1702925) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2013028146) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |