| NPI | 1386000461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: OR 451974) |
| Additional Taxonomies | 225XG0600X Occupational Therapist Gerontology (Licence: OR 451974) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |