| NPI | 1528318946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NV 0763) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 13362) |
| 225X00000X Occupational Therapist (Licence: MD 1064302) | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2014-09-18 |