| NPI | 1417238585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY 133070) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: KY KY-R3924) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2018-08-31 |