| NPI | 1629385125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KY R4562) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IN 31005045A) |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2018-08-06 |