| NPI | 1477550630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL 113654) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 10016) |
| Enumeration Date | 2005-07-03 |
| Last Update Date | 2012-01-11 |