| NPI | 1437341963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SD 0523) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NE 979) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |