| NPI | 1639207426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC002690L) |
| Additional Taxonomies | 376G00000X Nursing Home Administrator (Licence: PA NH005241L) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |