| NPI | 1518242692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: ND 1244) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 114374) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2012-11-26 |