| NPI | 1508313941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT60775472) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31006063A.) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2018-03-29 |