| NPI | 1508034901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31004360A) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY KY-R2925) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |