| NPI | 1508276270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CT 3888) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 10558) |
| 225X00000X Occupational Therapist (Licence: OR 292364) | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |