| NPI | 1437482957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: LA OTT.Z11853) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 019746-1) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2015-06-25 |