| NPI | 1649394099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: DC OT010000400) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 05746) |
| 225X00000X Occupational Therapist (Licence: CA OT4122) | |
| 225X00000X Occupational Therapist (Licence: VA 0119004495) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |