| NPI | 1407865074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT9377) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-02-28 |