| NPI | 1407134232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ID OT-993) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID 7021811-4201) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2011-07-27 |