| NPI | 1508306275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NH 2624) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MA 12204) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |