| NPI | 1417282872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MO 004808) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.004069) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |