| NPI | 1528030350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO 996174) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IA 00844) |
| 225X00000X Occupational Therapist (Licence: IL 056.006951) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2018-06-15 |