| NPI | 1417070244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT 004324) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC005131L) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2021-03-24 |