| NPI | 1427592559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT 16250) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 4746) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |