| NPI | 1508315466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31006558A) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: KY 171046) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2018-11-12 |