| NPI | 1366771651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 3926) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 13928) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2009-12-15 |