| NPI | 1386974657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 12795) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 5686) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2019-10-03 |