| NPI | 1588915946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WV 1588) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: PA OC012445) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |