| NPI | 1558657056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31002483A) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201007685) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |