NPI | 1366895187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 17090) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 17090) |
Enumeration Date | 2016-07-16 |
Last Update Date | 2016-07-16 |