| NPI | 1588822563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH 001797) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 06099) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2013-09-27 |