| NPI | 1609179829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT14146) |
| Additional Taxonomies | 225XG0600X Occupational Therapist, Gerontology (Licence: FL OT14146) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2010-12-09 |