| NPI | 1558651109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XG0600X Occupational Therapist, Gerontology (Licence: DC OT0100006766) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: VA 0119005205) |
| 225XG0600X Occupational Therapist, Gerontology (Licence: AR OTR2083) | |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2013-02-05 |