| NPI | 1447565288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201006221) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 10489) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |