| NPI | 1598176869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT 008513) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 116091) |
| 225X00000X Occupational Therapist (Licence: FL OT16292) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-15 |