| NPI | 1609951250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: IN 31001991A) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: IN 31001991A) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2016-06-15 |