| NPI | 1487774535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 8993) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: HI 735) |
| 225X00000X Occupational Therapist (Licence: ME OT2280) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2012-06-20 |