| NPI | 1447573852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119006855) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT1868) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2016-02-22 |